While the United States healthcare system is being asked to do more with less, it is also being required to improve quality. Initiatives are underway that will provide financial incentives for hospitals and physicians to encourage improved outcomes and will penalize providers that achieve poor outcomes. In the Mar. 16, 2006, edition of the New England Journal of Medicine, a study conducted by the Institute on Healthcare Improvement at Harvard University determined that only 55% of Americans are receiving appropriate care.
Today, many of the nation's approximately 7,000 community hospitals and health care facilities face similar challenges to improve patient care and to improve patient outcomes while facing a constrained healthcare budget and while further stressing a limited healthcare staff.
This reality affects a broad area of medicine, including the treatment of patients with heart failure, diabetes, bariatrics, prenatal, and the care of patients before and after outpatient procedures and surgery. For example, heart failure is the most common admitting diagnosis in US hospitals, and the numbers of people with chronic diseases are increasing. Readmission rates for heart failure are 20% at 30 days, and 50% at 6 months. Mortality rates are 12% at 30 days, 33% at 12 months and 50% at 4 years. Because of these disturbing trends, Medicare, the Joint Commission and others have identified heart failure outcomes as core measures of quality.
An abundance of evidence suggests that the best way to increase the level of quality care for the growing patient population is to work more closely with the patient to monitor and track their individual progress, and to exercise preventative intervention when necessary. Recently, the American College of Cardiology/American Heart Association Practice Guidelines for heart failure management recommend the use of disease management systems for heart failure.